New Customer Registration Form

Helms Salon Chemical Release Form:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail
example@example.com
I understand ang give my consent to the following:

Hair types and colors have varying effects from chemical treatments and I have been made aware of my responsibilities for disclosing important information to my stylist(s) and the possible effects in case a treatment was made prior without their knowledge that may result to adverse chemical reactions.I have made my stylist aware of all of the treatments I have had in the past three (3) months in order for them to assess the status of my hair and the process that they will make or recommend to me in order to achieve the results I desireIn order for me to achieve my desired results, I will have to be clear with my stylist of my desires and wishes for my hair. My stylist may give recommendations which I may adhere to, for which my stylist thinks or believe would be best for me.
By signing below, you release that Helms Salon, its stylist, colorist, and employees are not responsible and or liable concerning the application, processing, and/ or consenquences of the permanent chemical procedure of your hair.
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Helms Salon Chemical Release Form: